HomeMy WebLinkAboutHomestead_Chaddock II INDIANA SALES DISCLOSURE FORM SDF ID: 2014 Page 2
D. PREPARER
Teresa S. Holifield Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 _teres_a @swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)I GRANTOR(S)
Thomas R. Peck Helen A. Peck
Seller I -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1689 E Lincoln Pass 1689 E Lincoln Pass
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of medge and belief, is true,correct
and comple a/as requir by law, and is prepared in accordance with IC 6.1.1-5.5, lfal Prop rty Sales Disclosure Act".
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Signature of Seller i ✓ty
Si 'lure of eller
Thomas R. Peck 9/11/2014 Hel A. Peck _ 9/11/2014
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY LL OF E THA APPLY.
YES NO CONDITION YES NO CONDITION tSIB° ON CO
El ❑ 1. Will this property be the buyers primary Solar Energy Heating/Cooling System Homestead S� UOI R
residence? Provide complete address of primary T
❑ El 4. O
residence, including county:
❑ El 5. Wind Power Device
1689 East Lincoln Pass
Address(Number and Street) ❑ 2 6. Hydroelectric Power Device
',!Haubstadt, IN 47639 1 Gibson' ❑ 0 7. Geothermal Energy Heating/Cooling Device
City. State ZIP Code County ❑ El 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ El 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.)
ress(Number and Street)'
I tIgLIA- T-fJ LilG3o i:t)�rfrlct- 2d-a3 -/6.- 2 ooa.tiW3-oa51
City. State ZI de County Primary property owner contact name E-mail